Tumor Markers

Jack Maggiore, PhD, MLS(ASCP)
Reviewer: Kevin F. Foley, PhD, DABCC, MT, SC and Joshua J. Cannon, MS, MLS(ASCP)CMSHCM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Clinical Chemistry/UA/Toxicology): 1 hour(s)

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This course is intended to provide the basic information necessary regarding tumor markers and how they are used to detect, diagnose, and provide a prognosis of various cancers, as well as to provide an increased understanding of the many emerging biomarkers.

Objectives

  • Describe the features of a measurand that make for an ideal tumor marker.
  • Delineate the factors that limit the utility of a component as a tumor marker.
  • Correlate the presence of a tumor marker with its associated affected organ system.
  • Differentiate between carbohydrate-rich tumor markers, protein-rich tumor markers, enzymatic tumor markers, and oncofetal antigens.
  • List some of the emerging tumor markers for assessing breast cancer response to therapy and breast cancer risk.

Course Outline

  • Definitions and Background
    • Key Definitions
      • Cancer
      • Tumor Marker
    • Background
      • Cancer Prevalence and Relative Risk
      • Cancer Prevalence - New Cancer Cases by Site
      • Cancer Predispositions
      • Early Detection is Crucial
      • Which statement would not fit the definition of a tumor marker?
    • The Ideal Tumor Marker
      • Specificity
        • The Ideal Tumor Marker Would Have 100% Specificity
      • Sensitivity
        • The Ideal Tumor Marker Would Have 100% Sensitivity
      • Concentration and Tumor Mass
        • The Ideal Tumor Marker Would Be Indicative of Tumor Mass
      • Analytical Aspects
        • The Ideal Tumor Marker Would be Detectable in Blood or Biological Fluids
        • The Ideal Tumor Marker Would be Adaptable to Laboratory Analysis
        • True or False: Ideally, for a tumor marker to be considered as a screening tool, it should be consistently elevated at the early stages of the disease so that the diagnostic sensitivity is near 100% and elevated only when the cancer of interest is present so that the diagnostic specificity is near 100%.
        • Reference Values
      • Reality
        • Providing Diagnostic and Prognostic Support
      • Examples of Tumor Markers
        • Components
      • Hormones
        • Primary and Ectopic Hormones
        • Example of Ectopic Production of Hormone from Lung Tumor
        • Hormones as Tumor Markers
        • Regarding hormone production, what is the term associated with producing a hormone at a distant site by non-endocrine tissue?
      • Specific Proteins
        • Specific Proteins as Tumor Markers
        • Specific Proteins as Tumor Markers - Monoclonal Immunoglobulins
        • Specific Proteins as Tumor Markers - Diagnostic Utility
        • True or False: Detecting an immunoglobulin clone, such as IgM, is always associated with a malignant condition, such as multiple myeloma.
      • Enzymes
        • Enzymes as Tumor Markers
        • Prostate-Specific Antigen (PSA): Background
        • Prostate-Specific Antigen (PSA): Biochemistry and Genetics
        • Prostate-Specific Antigen (PSA): Clinical Applications
        • Prostate-Specific Antigen (PSA): Clinical Applications in Early Detection of Prostate Cancer
        • Prostate-Specific Antigen (PSA): Clinical Applications in Prostate Cancer Screening (continued)
        • Prostate-Specific Antigen (PSA): Clinical Applications in Prostate Cancer Staging
        • Prostate-Specific Antigen (PSA): Clinical Applications of Monitoring Treatment
        • Prostate-Specific Antigen (PSA): Clinical Applications in Monitoring Recurrence
        • Prostate-Specific Antigen (PSA): Controversy
        • The clinical utility of prostate-specific antigen (PSA) as a tumor marker includes which of the following?
      • Carbohydrate Markers
        • Carbohydrate Tumor Markers
        • The Mucin-Rich Carbohydrate Tumor Markers
        • CA 125
        • CA 15-3
        • CA 549
        • CA 27.29
      • Blood Group Antigen-Related Cancer Markers
        • Blood Group Antigens as Tumor Markers
        • CA 19-9
      • Receptors
        • Tumor Marker Receptors
        • Estrogen and Progesterone Receptors
        • Human Epidermal Growth Factor Receptor 2 (HER2/neu)
      • Oncofetal Antigens
        • The Oncofetal Antigens
        • Alpha Fetoprotein (AFP)
        • Carcinoembryonic Antigen (CEA)
      • Mutations of Tumor Suppressor Genes
        • Breast Cancer Susceptibility Proteins
      • References
        • References

Additional Information

Level of instruction: Beginning
Intended audience:  Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author information: Jack A. Maggiore, PhD, MT(ASCP) is an Assistant Professor and Associate Laboratory Director of the Core Laboratory Operations and Point of Care Testing at Loyola University Medical Center in Maywood, Illinois. Dr. Maggiore is a medical technologist, certified by the ASCP, with a Master of Science in Clinical Chemistry and a Doctorate in Pathology from the University of Illinois. His expertise includes clinical instrumentation, method development and validation, quality assurance, medical device clinical trials, and scientific regulatory affairs. His clinical research interests include the development of novel biomarkers for chronic diseases using blood spots and other non-conventional samples. Dr. Maggiore holds several medical device patents, has authored more than fifty peer-reviewed and invited publications and textbook chapters, and has presented his research findings at international scientific society meetings. Dr. Maggiore's mission is to work with healthcare professionals to empower consumers to take a more active role in their health maintenance.
Reviewer Information: 
Kevin F. Foley, PhD, DABCC, MT, SC, is the director of clinical pathology for the Kaiser Permanente Northwest region. He also teaches clinical chemistry at Oregon Health Sciences University. Dr. Foley earned his PhD in clinical pharmacology and toxicology at East Carolina School of Medicine in North Carolina.
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab. His areas of expertise and professional passions include clinical hematology and interprofessional education.